Controversial NHS regulations raised in Commons

HSJ live logo

HSJ live logo

6.20pm: Shadow Health Secretary Andy Burnham MP tweets: “Labour has just tabled a motion, with Green & Lib Dem support, opposing s75 regulations on #NHS competition. Ask your MP to sign EDM 1104.”

5.30pm: The Royal College of Nursing has added its voice to concerns over secondary legislation on NHS competition laid before Parliament.

Dr Peter Carter, chief executive said: “During the passage of the Health and Social Care Act, the RCN expressed its concerns that care should not become fragmented through further competition. We have been clear that collaboration must be encouraged.

“By skewing the system in favour of competition, the NHS risks putting price ahead of the need to deliver high quality care. We welcomed Government amendments and Ministerial statements at the time which appeared to safeguard against competition, after assurances were made about the role of Monitor which were expected to be reinforced via secondary legislation.

“However now that the new regulations are before parliament, the RCN is concerned that the focus on competition rather than collaboration remains. Recent events have made clear that the NHS cannot allow itself to be diverted away from delivering high quality care, and the RCN is urging the Government and parliamentarians to reflect this as the Health and Social Care Act is implemented.”

3.40pm: BREAKING NEWS: Controversial changes to reduce NHS staff terms and conditions have been agreed by unions and NHS Employers.

3.10pm: Clinical commissioning groups have warned they are at risk of being “saddled with an inherited debt” when they take on their new powers, as a result of an onslaught of retrospective claims for NHS continuing healthcare funding.

The warning – from representative group NHS Clinical Commissioners – came as the Department of Health confirmed primary care trusts had so far received around 60,000 backdated requests for continuing care funding in 2012-13.

Read the analysis by HSJ.

3pm: One in four healthcare professionals have reported their organisation has been the subject of some sort of data breach, according to new research.

The survey included consultants, doctors, senior managers, facilities managers and IT managers – of which over half were from hospitals.

A total of 27 per cent of those completing the survey were aware of a significant data loss in their organisation.

Two-thirds said the data breach was a direct result of incorrect disposal whilst, worryingly, another third attributed the loss to the action of criminals, such as theft.

The survey was carried out for the Information Destruction Section of the British Security Industry Association (BSIA).

More details available here.

2.40pm: The Alzheimer’s Society has said less than half of the 322,000 people living with dementia in care homes are enjoying a good quality of life.

The society has said eight out of every 10 residents in a care home - more than previously though, have either dementia or severe memory problems.

Only 41 per cent of relatives surveyed by Alzheimer’s Society reported that their loved ones enjoyed good quality of life. Despite this, three quarters would recommend their family member’s care home.

Find out more here or download the report (see right).

2.30pm: More than 72,465 NHS staff have made a pledge for the NHS Change Day event on March 13.

The event is aimed at encouraging staff to voluntarily commit to taking an action that demonstrates their commitment to improving patient care and create a movement which could lead to more NHS Change Days. It has been supported by NHS leaders including NHS medical director Sir Bruce Keogh.

Find out more here.

2.05pm: The British Medical Association has raised concerns patient care could suffer if CCGs try to achieve the targets set out in the NHS Outcomes Framework.

BMA GPs committee chair Laurence Buckman said GP leaders were strongly encouraging doctors on CCG boards to consider whether it was possible to achieve quality premium payments while remaining ‘professional’.

He said: “The reality is that by setting financial targets that are virtually undeliverable, you either have to cut service to patients in a way that we regard as unprofessional … or you have to say “Well, actually, we can’t do this”.

Read the details of the BMA concerns here.

1.58: Tweet from @reformthinktank: #healthyinnovation Earl Howe: the NHS needs the courage and knowledge to buy for value.

1.45pm: Senior Conservative backbencher Nicl De Bois, secretary of the influential 1922 Committee of Tory MPs, has told the Daily Telegraph he will back calls for Sir David Nicholson to resign as NHS Chief Executive.

Mr de Bois said he will sign the Early Day Motion tabled by fellow Conservative MP Charlotte Leslie. He told the Telegraph: “Although I appreciate the position of the Prime Minister I don’t think this is a question of finding a scapegoat. This is about accountability and there is a sense of a lack of accountability in the NHS organisation.

“David Nicholson should reflect on his position.”

1.30pm: The NHS is set to lose 12,000 nurses by the next election, according to the Labour Party.

According to the party’s latest analysis (see right) of the NHS workforce 4,000 nursing jobs have already been lost since the 2010 election and at the current rate of job losses this will see 12,000 nursing jobs axed by 2015.

Additional figures, obtained by a Freedom of Information request, show four in ten of the lost jobs come from hospital and community services primarily concerned with the care of older people.

A further two in ten have been lost from maternity services and another two from psychiatry.

The Labour Party said it accepted the recommendations on staffing levels made by Robert Francis QC and has urged the Government to adopt them.

Shadow Health Secretary Andy Burnham said: “Thousands of nursing jobs have been lost across the country as the NHS struggles with the toxic mix of cuts and re-organisation. 

“Ministers promised no cuts to the NHS frontline and, if they don’t step in to reverse this worrying trend, it will be very difficult to implement standard nurse-patient ratios as raised by the Francis Report.”

1.05pm: Here is what Lord Howe said in the House of Lords in March 2010 on ammendments to regulations.

“Clinicians will be free to commission services in the way they consider best. We intend to make it clear that commissioners will have a full range of options and that they will be under no legal obligation to create new markets….” (6/3/12, Hansard4)

At the moment the regulations would oblige commissioners “to create [a] new market” if they awarded a contract without a competition, and Monitor ruled they didn’t have grounds to.

The grounds in the legislation are “technical reasons” or “reasons of extreme urgency”.

The rules banning commisisoners from “anti-competitive behaviour” say: “an arrangement for the provision of health care services for the NHS must not include any restrictions on competition that are not necessary”.

HSJ has been told this would mean any restriction on competition would have to be clinically justified. This means commissioners could not award an exclusive contract to an NHS provider, claiming the overall financial viability of the trust depended on it.

12.58pm: Lib Dem MP John Pugh tweets: “@johnpughmp: Lib Dems will press for a withdrawal of s75 competition regulations- not in line with undertakings given by Andrew Lansley and Earl Howe.”

12.47: Health Select Committee member Andrew George MP asked Minister Norman Lamb to withdraw the Section 75 secondary legislation regulations.

The Minister replied to say the Government was “looking at this extremely seriously. There were clear assurances given in the other place (House of Lords) during the passage of the legislation.”

He said the Government would ensure the regulations complied with that legislation.

12.45pm: Shadow Health Secretary Andy Burnham says Labour analysis suggests there will be a fall of 12,000 nurses in the NHS during the life of the current Parliament.

He told the House of Commons four in 10 of the cuts were in services for elderly people. The analysis is due to be released later today.

12pm: Labour’s shadown minister Liz Kendall MP accuses the Government of being “woefully complacent” on its failure to publish the sexual health strategy which she says has been delayed by 21 months.

Public Health Minister Anna Soubry replies to say the strategy is very important adding “we are working hard to make sure it is absolutely right.”

She says any delay does not prevent the right commissioning at a local level.

11.50am: Joan Ruddick MP asks Hunt to apologise for misleading Commons after saying Sir Bruce Keogh said Lewisham changes would save 100 lives.

Hunt replies to say he won’t apologise and argues Sir Bruce Keogh accepted the review and calculations over changes to Lewisham A&E and that as Secretary of State he accepted Sir Bruce’s conclusions.

11.45am: Health Secretary Jeremy Hunt is taking questions in the House of Commons.

Watch live via Parliament TV here.

11.25: Five non-executive directors positions are available on the board at the Care Quality Commission.

The applicants should have a track record of significant achievement at the most senior levels throughout their career. The role would require a time commitment of two to three days per month and the length of the appointments will be determined by the Secretary of State, up to a maximum of four years. Details here.

11.10am: Two Dorset trusts involved in the first merger of two foundation trusts could be prevented from freely communicating with each other while the Competition Commission reviews the case, HSJ has learned.

The merger between Royal Bournemouth and Christchurch Hospitals and Poole Hospital foundation trusts was referred to the commission by the Office of Fair Trading in January this year.

HSJ understands the commission has asked the trusts to sign undertakings committing not to hold discussions without the presence of independent observers while the review, due to complete in June, takes place.

11.02am: HSJ reporter James Illman tweets from Reform innovation event: “@jamesillman: a few highlights from Darzi at #healthyinnovation -NHS still not very good at innovation (As we know). The new CCG model will not help.”

Adding: “Darzi at #healthyinnovation No CCG is going to be able to have enough power over a big provider like Imperial to tell them what to do”

10.55am: A Parliamentary motion has been tabled by Conservative MP Charlotte Leslie calling on NHS Chief Executive Sir David Nicholson to resign following the report of the Mid Staffordshire Foundation Trust Public Inquiry earlier this month.

Details of the Early Day Motion by the Bristol North MP can be found here.

10.50am: Health minister Lord Howe has defended the government’s regulations on competition which have been criticised after being laid before Parliament.

The NHS (Procurement, Patient Choice and Competition) Regulations 2013, created under the Health Act, were published earlier this month. They will come into force on April 1.

They have been criticised by anti-independent sector campaigners, who have said they contradict commitments made by the government during the passage of the Act.

However, Lord Howe said in a statement: “There is no Government policy to privatise all NHS services.

10.45am: In a twitter reply to Clive Pedell, co-leader of National Health Action party, Dr Sarah Wollaston MP (@drwollastonmp) has said she will be asking the Health Select Committee to formally look into legisaltion which will open up the NHS to competition and the way the OFT are intervening in mergers.

10.40am: The Royal College of Midwives has claimed secondary legislation under Section 75 of the Health and Social Care Act will lead to fragmented NHS midwifery services and poorer care.

The RCM said the regulations, which could increase the number of NHS services put out to tender, were a particular threat to midwifery services.

Jon Skewes, director for policy, employment relations and communications at the Royal College of Midwives, said: “I am deeply disappointed with the Government because they seem to have promised one thing and delivered the opposite.

Read the full statement here.

10.20am: HSJ journalist James Illman is attending an event hosted by thinktank Reform on Healthy Innovation.

Lord Darzai, chair of Institute of Global Health Innovation, at Imperial College London will be speaking at the event.

Follow James’ tweets via @Jamesillman.

10.15am: The Treasury’s response to the Public Accounts Committee report on diabetes care has been criticised by Barbara Young, chief executive of Diabetes UK.

She said the charity was “saddened and disappointed by the Government’s response.”

In a statement she said: “While we welcome the fact the Government has identified some targets for what needs to happen, it is unclear how this improvement will be achieved. Another five years to deliver modest improvements in the quality of care that people with diabetes receive does not reflect the urgency and priority of this, one of the biggest health challenges of our time.

“We are also disappointed that the Government has ruled out a public campaign to stem the rising tide of diabetes. Given the rapid rise in the number of people with Type 2 diabetes, this kind of campaign from which heart disease, stroke and the cancers have benefited, is badly needed. Why not for diabetes, which is now four times more prevalent than all the cancers combined?”

10.05am: The Treasury has published its response to the Public Accounts Committee report in November which found diabetes care in England was “depressingly poor.”

The Government has agreed with the committee’s recommendation for universal coverage in diabetes care and has set improvement targets of 64 per cent by March 2015 and 80 per cent by March 2018.

You can read the full treasury response here.

9.48am: Shadow health secretary Andy Burnham is expected to raise the Francis report at Commons health questions today, around lunchtime. He is also expected to publish information collected by the Labour party about NHS performance.

Mr Burnham - who himself was a minister involved in decisions about Mid Staffordshire Foundation Trust during its serious care failures - has so far not heavily criticised the current government in relation to Francis.

HSJ Live will provide rolling coverage Mr Burnham’s statements and the debate today.

7.55am Good morning, the Francis report provides the single greatest leadership challenge the NHS has ever faced, writes Aidan Halligan on HSJ today. He looks at what kind of leadership programmes should be used in future so that the new cadre of leaders allow and redefine self-regulation, self-policing and embrace a philosophy of positive preoccupation with failure.